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A Journal on Surgery

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Minerva Chirurgica 2001 August;56(4):345-50

language: Italian

Biliary-intestinal bypass in the treatment of severe obesity: personal experience on 23 patients

Galati G., Izzo L., Binda B., De Cesare A., Fiori E., Bononi M., Masoni L., Badiali M.


Background. The aim of this study was to determine the efficacy and safety of biliary-intestinal bypass in severely obese subjects (Body Mass Index > 35).
Methods. From January to December 1999, 23 patients (8 men and 15 women, mean age 36.6 years: range 20-51) affected with primary morbid obesity (BMI >40: range 40.1-64.7), in whom different attempt using conservative medicine have proved non-resolutive, underwent biliary-intestinal bypass. After the operation all the patients have been followed- up for 12 months.
Results. The mean Body Mass Index was reduced to 36.9 (range 27.7-44.1) after 6 months and to 33 (range 24.9-40.1) after 12 months. Peri and postoperative mortality was zero. Excessive malabsorption was efficaciously controlled by adeguate replacement therapy. Diarrhoea, common complicance of every operation inducin malabsorbition, was reduced to 2-3 evacuation a day after 2-3 months.
Conclusions. On the basis of personal experience it is underlined that biliary-intestinal bypass, as surgical treatment of morbid obesity refractory to medical therapy, is today a safe and effective operation (up to 80% of excess body weight lose); the presence of biliary-intestinal anastomosis reduces the post-operative loss of bile acids, choleretic diarrhoea and electrolytic disorders.

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